Recurrent severe angioedema associated with imidapril and diclofenac.
BACKGROUND
Angioedema due to angiotensin-converting enzyme inhibitors (ACEIs) therapy occurs not infrequently and is sometimes associated with life-threatening conditions.


METHODS
A 59-year-old woman presented with recurrent angioedema of the tongue complicated by upper airway obstruction which required endotracheal intubation. Laboratory tests including complement levels were normal. ACEI-associated angioedema precipitated by NSAIDs was suspected. Her condition improved after discontinuation of imidapril and diclofenac without other specific treatment.


CONCLUSIONS
ACEIs, and in particular concomitant use with NSAIDs, should be avoided in patients with a history of angioedema because continuing administration tends to lead to more severe attacks.
Kampitak
Thatchai
T
Department of Internal Medicine, Chulalongkorn University Hospital, Bangkok, Thailand. thatchai_k@yahoo.com
D000402:Airway Obstruction / Q000209:etiology / Q000503:physiopathology / Q000628:therapy*; D000799:Angioedema / Q000139:chemically induced* / Q000175:diagnosis / Q000503:physiopathology; D000806:Angiotensin-Converting Enzyme Inhibitors / Q000008:administration & dosage / Q000009:adverse effects*; D000894:Anti-Inflammatory Agents, Non-Steroidal / Q000008:administration & dosage / Q000009:adverse effects*; D003924:Diabetes Mellitus, Type 2 / Q000188:drug therapy; D004008:Diclofenac / Q000008:administration & dosage / Q000009:adverse effects*; D004359:Drug Therapy, Combination; D005260:Female; D006801:Humans; D048289:Imidazolidines / Q000008:administration & dosage / Q000009:adverse effects*; D007442:Intubation, Intratracheal; D008875:Middle Aged; D010146:Pain / Q000188:drug therapy; D028761:Withholding Treatment
D000806:Angiotensin-Converting Enzyme Inhibitors; D000894:Anti-Inflammatory Agents, Non-Steroidal; D048289:Imidazolidines; D004008:Diclofenac; C065166:imidapril